Authors' response: Patient Health Questionnaire-2 as a screening tool for psychological distress in brain tumor patients.

摘要

We concur with Kawada that ideally, standard psychiatric diagnostic instruments, such as the Structured Clinical Interview for the DSM-IV, should be chosen as golden standards when assessing diagnostic accuracy of psychological distress self-rating scales for screening of mental disorders. Because of logistic reasons, we were unable to apply diagnostic interview, which is the limitation of our study. However, the Hospital Anxiety and Depression Scale (HADS) and Beck Depression Inventory II (BDI-II) are valid instruments for screening of mental disorders and for measuring psychological distress symptom severity. From clinical perspective, conciseness and user-friendliness can be considered as the major advantages of the Patient Health Questionnaire (PHQ-2) possibly preventing from excessive burden to routine health care settings, such as the neurosurgery department. Indeed, the American Heart Association has recommended the PHQ-2 as an initial step in a three-step diagnostic algorithm for identifying depressed CAD patients, followed by more comprehensive PHQ-9, and then by the Structured Clinical Interview [1]. In this regard, our study covers two first steps suggested by the American Heart Association. However, the clinical value of the PHQ-2 in neuro-oncology setting remains largely unclear mainly because studies assessing diagnostic utility of the PHQ-2 in patients with brain tumors are sparse.